Monitoring the loss of botulinum toxin during intradetrusor administration – pilot study results

Česká verzia

Authors: Vladimír Šámal ^1,2; Jana Műllerová ³; Vít Paldus ¹; Jan Mečl ¹
Authors place of work: Urologické oddělení, Krajská nemocnice Liberec, a. s. ¹; Urologická klinika Fakultní nemocnice a Lékařské fakulty UK, Hradec Králové ²; Katedra chemie, Fakulta přírodovědně humanitní a pedagogická, Technická univerzita Liberec ³
Published in the journal: Ces Urol 2014; 18(1): 33-39
Category: Original article

Summary

Aim:
The aim of this study was to examine the possible loss of the onabotulinumtoxinA (onaBTA) in the course of endoscopic injection into the detrusor muscle in patients with neurogenic detrusor overactivity.

Methods:
The study group included 11 patients with neurogenic detrusor overactivity who failed standard treatment with anticholinergics. Patients were treated with endoscopic injection of 200 U onaBTA divided into 30 injection sites using a 23 G flexible endoscopic needle. In order to determine the content of onaBTA lost during endoscopic administration, methylene blue dye was added to the solution of the drug. The concentration of methylene blue was quantified using spectrofotometry in the bladder irrigant collected immediately after the final intradetrusor injection. The volume of onaBTA that was lost in the course of each procedure was subsequently calculated based the concentration of methylene blue in the solution.

Results:
In the first patient, the method for monitoring the loss of onaBTA was performed using a known loss of 13 U of onaBTA. In the following 10 patients there was a loss of 2.6 ± 1.67 U onaBTA during endoscopic administration onaBTA to detrusor.

Conclusions:
In this pilot study, we demonstrated that compared to the total injected volume, the loss onaBTA during endoscopic injection in the detrusor was negligible.

Key words:
botulinum neurotoxin, onabotulinumtoxinA, neurogenic detrusor overactivity, endoscopic administration, detrusor injection.

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